11 research outputs found

    An unusual case of pilomatrix carcinoma of the salivary glands in a young man

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    We describe here a rare case of pilomatrix carcinoma in the right parotid region, arising in a young patient.Pilomatrix carcinoma is a rare, locally aggressive tumor with a tendency to recur. Pilomatrixoma is a superficial benign skin tumor arising from the matrix cells of the hair follicle generally located in the scalp, face, and upper limbs. Clinically, it usually presents as a solitary subcutaneous blue-black nodule which grows slowly.An 18-year-old male, non-smoker, in good health, was referred to our Unit after the onset of a swelling in the right parotid region. The lesion had been present for 1 year but the patient did not seek medical attention in that time. Clinical examination showed an exophytic mass in the right parotid region measuring 20 × 20 mm. An ultrasound of the major salivary glands showed an oval lesion of the right parotid gland; contrast-enhanced MRI appeared to show an oval lesion in the right intraparotid region, approximately 20 × 25 mm, which was hypointense in T1 images, and hyperintense in T2 images, with inhomogeneous contrast-enhancement; Fine Needle Aspiration Cytology (FNAC) was indicative of a lesion with high suspicion of malignancy.We elected to carry out a facial nerve sparing total parotidectomy, under general anesthesia, and facial reconstruction of the remaining gap with a sternocleidomastoid muscle flap. Histopathological analysis demonstrated basaloid cell proliferation beneath granulation tissue, hemorrhage, and large number of “ghost cells” with high mitotic activity. This confirmed the diagnosis of pilomatrix carcinoma. Postoperative outcome was uneventful

    The Combination of Inflammatory Biomarkers as Prognostic Indicator in Salivary Gland Malignancy

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    The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs)

    Support Tools in the Differential Diagnosis of Salivary Gland Tumors through Inflammatory Biomarkers and Radiomics Metrics: A Preliminary Study

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    Simple Summary The management of salivary gland tumors (SGTs), especially their early diagnosis, remains a challenge for physicians. Indeed, differentiating benign and malignant SGTs is an essential step in choosing an appropriate surgical approach. The aim of this study was to increase the effectiveness of pre-surgical diagnosis through a machine learning (ML) diagnostic tool that evaluates inflammatory biomarkers and radiomic metrics extracted from magnetic resonance imaging (MRI) sequences. Specifically, we considered the following indices of inflammation as inflammatory biomarkers: the systemic immune-inflammation index (SII), the systemic inflammation response index (SIRI), the platelet-to-lymphocyte ratio (PLR), and the neutrophil-to-lymphocyte ratio (NLR). In the context of cancer research, however, radiomics enables high-performance quantitative analysis of radiological images. We concluded that inflammatory biomarkers and radiomic features are comparably capable of supporting a differential diagnosis and are easily obtained through the preclinical investigations of patients. Background: The purpose of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), and radiomic metrics (quantitative descriptors of image content) extracted from MRI sequences by machine learning increase the efficacy of proper presurgical differentiation between benign and malignant salivary gland tumors. Methods: A retrospective study of 117 patients with salivary gland tumors was conducted between January 2015 and November 2022. Univariate analyses with nonparametric tests and multivariate analyses with machine learning approaches were used. Results: Inflammatory biomarkers showed statistically significant differences (p < 0.05) in the Kruskal-Wallis test based on median values in discriminating Warthin tumors from pleomorphic adenoma and malignancies. The accuracy of NLR, PLR, SII, and SIRI was 0.88, 0.74, 0.76, and 0.83, respectively. Analysis of radiomic metrics to discriminate Warthin tumors from pleomorphic adenoma and malignancies showed statistically significant differences (p < 0.05) in nine radiomic features. The best multivariate analysis result was obtained from an SVM model with 86% accuracy, 68% sensitivity, and 91% specificity for six features. Conclusions: Inflammatory biomarkers and radiomic features can comparably support a pre-surgical differential diagnosis

    FKBP51 Immunohistochemical Expression: A New Prognostic Biomarker for OSCC?

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    Up-to-date, several molecular markers of prognosis have been studied in Oral Squamous Cell Carcinoma (OSCC), but none entered in the clinical setting. Therapy of OSCC tumors mainly relies on surgery, radiotherapy and partially on chemotherapy; there is an urgent need for biomarkers able to better stratify OSCC patients’ risk to address targeted therapeutic strategies. The role of immune response in the pathogenesis and biological behavior of OSCC has been investigated by several authors, and promising results have been obtained with immune checkpoint inhibitors. We already investigated the role of the immune modulator FK506-binding protein 51 (FKBP51), a FK506-binding immunophilin, in cutaneous melanoma biology, and its expression in several human solid tumors. In the present study, we aimed to assess the value of FKBP51 expression in OSCC tumor cells as a marker of outcome. We collected clinical data from 72 patients who underwent surgery for Squamous Cell Carcinoma (SCC) of the tongue, floor, lips and palate. FKBP51 expression was assessed by immunohistochemistry on paraffin-embedded tumor tissues. In addition, we evaluated the human papillomavirus (HPV) status of primary tumors by immunohistochemistry, viral subtyping and In Situ Hybridization (ISH) assay. We found that high FKBP51-expressing tumors characterized the OSCCs with the worst prognosis: the high immunohistochemical expression of FKBP51 associated with death occurring within five years from the diagnosis with a sensitivity of 88.46% and a specificity of 91.67%. The estimated positive predictive value of the test was 88.45% and negative predictive value 91.67%. We tested FKBP51 mRNA presence, by RT-PCR assay, in a selected series of OSCC tumors, and we found that mRNA correlated well to the protein expression and to the clinical outcome. Applying the Bayes formula, we estimated an 88% probability of dying within five years from the diagnosis of OSCC patients with a high FKBP51 immunohistochemical (IHC) test result (>51% of FKBP51 positive tumor cells). On the basis of our analysis, we propose tumor tissue expression of FKBP51 protein as a reliable prognostic marker for OSCC tumors

    Renal function and cardiac adrenergic impairment in patients affected by heart failure

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    Although in heart failure (HF) there is a strict correlation between heart and kidney, no data are available on the potential relationship in HF between renal dysfunction (RD) and the impaired sympathetic innervation. Aim of the present study was to assess the relationship between RD and cardiac sympathetic innervation in HF patients with reduced ejection fraction. Two hundred and sixty-three patients with mild-to-severe HF underwent iodine-123 meta-iodobenzylguanidine myocardial scintigraphy to assess sympathetic innervation, evaluating early and late heart-to-mediastinum (H/M) ratios and washout rate. In all patients, glomerular filtration rate (eGFR) by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was assessed. A direct association was found between EPI-eGFR and late H/M (r = .215; P < .001). Dividing the population into moderate-to-severe eGFR reduction and normal-to-mildly reduced eGFR (cutoff ≤ 60 mL·min-1·1.73 m-2), a statistically significant reduction of late H/M value was found in patients with RD compared to patients with preserved eGFR (P = .030). By multivariable linear regression analysis, eGFR resulted in the prediction of impaired late H/M in patients with RD (P = .005). Patients with RD and HF show more impaired cardiac sympathetic activity than HF patients with preserved renal function, and reduced eGFR is a predictor of reduced late H/M
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